Healthcare Provider Details

I. General information

NPI: 1619187945
Provider Name (Legal Business Name): MEREDITH ASHLEY LAKEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 11/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 JEFFERSON HWY
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

5305 MEMPHIS ST
NEW ORLEANS LA
70124-1735
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-0328
  • Fax:
Mailing address:
  • Phone: 205-249-4376
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number103661
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License Number51167
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number25701
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberD68653
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: